A nurse is caring for a client who experienced a lacerated spleen and has been on bedrest for several days. The nurse auscultates decreased breath sounds in the lower lobes of both lungs. The nurse should realize that this finding is most likely an indication of which of the following conditions?

A. "I will feel less hungry during meals while I am taking orlistat": Orlistat works by blocking the absorption of dietary fat in the intestines rather than suppressing appetite. Therefore, it does not typically reduce hunger during meals.
B. "I will eat a no-fat diet to prevent side effects from the medication": Orlistat can cause gastrointestinal side effects such as oily stools, fecal incontinence, and flatulence, particularly when consumed with high-fat meals. While reducing fat intake can help minimize these side effects, it is not necessary to eliminate fat entirely from the diet. The statement is partially correct but not the best response indicating full understanding.
C. "I will stop taking orlistat and call my doctor if my urine gets darker in color": Dark urine can indicate liver problems, which are a potential side effect of orlistat. Therefore, it is crucial for the client to monitor for this symptom and contact their healthcare provider if it occurs. This response indicates that the client understands the potential adverse effects of the medication.
D. "I will take my dose of orlistat every morning an hour before breakfast": Orlistat is typically taken with meals or up to one hour after eating. Taking it on an empty stomach before breakfast is not recommended.

A. Provide reassurance to the client and parents: While reassurance is important, it is not the priority action when caring for an adolescent client with a newly applied fiberglass cast for a fractured tibia. Ensuring adequate neurovascular status is critical to prevent complications associated with impaired circulation or nerve function.
B. Perform a neurovascular assessment: This is the correct action and the priority when caring for a client with a newly applied cast. The nurse should assess the client's neurovascular status by evaluating circulation, sensation, and movement distal to the casted limb. Changes in color, temperature, sensation, or movement could indicate impaired circulation or nerve function, which require immediate intervention to prevent complications such as compartment syndrome.
C. Apply an ice pack to the casted leg: While applying ice may help reduce swelling and discomfort, it is not the priority action when caring for a client with a newly applied cast. Additionally, applying ice directly to the cast may not effectively reach the skin and underlying tissues, potentially causing discomfort without providing significant benefit.
D. Explain the discharge instructions to the client and parents: Providing discharge instructions is important for client education, but it is not the priority action immediately after applying a cast. Ensuring the client's safety and well-being by performing a neurovascular assessment takes precedence to identify and address any potential complications associated with the cast.